"Do Masks Work?"

[George K]

https://www.city-journal.org/do-masks-work-a-review-of-the-evidence?wallit_nosession=1

First of all he talks about public health being driven by observational, rather than random controlled trials:

A randomized controlled trial divides participants into different groups on a randomized basis. At least one group receives an “intervention,” or treatment, that is generally tested against a control group not receiving the intervention. The twofold strength of an RCT is that it allows researchers to isolate one variable—to test whether a given intervention causes an intended effect—while at the same time making it very hard for researchers to produce their own preferred outcomes.

The author gives a long explanation of the CDC's reliance on observational, rather than RCT studies on the effectiveness of masks.

The RCT eventually became firmly established as the most reliable way to test medical interventions. The following passage, from Abdelhamid Attia, an M.D. and professor of obstetrics and gynecology at Cairo University in Egypt, conveys its dominance:

"The importance of RCTs for clinical practice can be illustrated by its impact on the shift of practice in hormone replacement therapy (HRT). For decades HRT was considered the standard care for all postmenopausal, symptomatic and asymptomatic women. Evidence for the effectiveness of HRT relied always on observational studies[,] mostly cohort studies. But a single RCT that was published in 2002 . . . has changed clinical practice all over the world from the liberal use of HRT to the conservative use in selected symptomatic cases and for the shortest period of time. In other words, one well conducted RCT has changed the practice that relied on tens, and probably hundreds, of observational studies for decades."

Finally, he talks about COVID-19:

The only RCT to test mask-wearing’s specific effectiveness against Covid-19 was a 2020 study by Bundgaard, et al. in Denmark. This large (4,862 participants) RCT divided people between a mask-wearing group (providing “high-quality” three-layer surgical masks) and a control group. It took place at a time (spring 2020) when Denmark was encouraging social distancing but not mask use, and 93 percent of those in the mask group wore the masks at least “predominately as recommended.” The study found that 1.8 percent of those in the mask group and 2.1 percent of those in the control group became infected with Covid-19 within a month, with this 0.3-point difference not being statistically significant.
This study—the first RCT on Covid-19 transmission—apparently had difficulty getting published. After the study’s eventual publication, Vinay Prasad, an M.D. at the University of California, San Francisco, described it as “thoughtful,” “useful,” and “well done,” but noted (with criticism), “Some have turned to social media to ask why a trial that may diminish enthusiasm for masks and may be misinterpreted was published in a top medical journal.”

Meanwhile, the CDC website portrays the Danish RCT (with its 4,800 participants) as being far less relevant or important than the observational study of Missouri hairdressers with no control group, dismissing the former as “inconclusive” and “too small” while praising the latter, amazingly, as “showing that wearing a mask prevented the spread of infection”—when it showed nothing of the sort.

Each of the RCTs discussed so far, 13 in all, examined the effectiveness of surgical masks, finding little to no evidence of their effectiveness and some evidence that they might actually increase viral transmission. None of these 13 RCTs examined the effectiveness of cloth masks. “Cloth face coverings,” according to former CDC director Robert Redfield, “are one of the most powerful weapons we have.”

Finally:

In sum, of the 14 RCTs that have tested the effectiveness of masks in preventing the transmission of respiratory viruses, three suggest, but do not provide any statistically significant evidence in intention-to-treat analysis, that masks might be useful. The other eleven suggest that masks are either useless—whether compared with no masks or because they appear not to add to good hand hygiene alone—or actually counterproductive. Of the three studies that provided statistically significant evidence in intention-to-treat analysis that was not contradicted within the same study, one found that the combination of surgical masks and hand hygiene was less effective than hand hygiene alone, one found that the combination of surgical masks and hand hygiene was less effective than nothing, and one found that cloth masks were less effective than surgical masks.

Hiram Powers, the nineteenth-century neoclassical sculptor, keenly observed, “The eye is the window to the soul, the mouth the door. The intellect, the will, are seen in the eye; the emotions, sensibilities, and affections, in the mouth.” The best available scientific evidence suggests that the American people, credulously trusting their public-health officials, have been blocking the door to the soul without blocking the transmission of the novel coronavirus.

That Danish study had difficulty getting published.

The hell you say.

[Axtremus]

Knowing what you know now, would you go without masks when visiting other indoor places where there are other people who will be in your proximity?

Just curious if the reported meta analysis is substantial enough to chang your behavior.

[George K]

@axtremus said in "Do Masks Work?":

Just curious if the reported meta analysis is substantial enough to chang your behavior.

Nah, I'll still mask up. I've stated many times that I have my doubts about the effectiveness of masks, particularly cloth ones.

Just curious if the reported meta analysis is substantial enough to chang your behavior.

The Danish study is not a meta-analysis, is it?

[Jolly]

In the small hospital lab where I occasionally work, the masks are taken off after we walk into the lab.

We haven't had a single case of worker-to-worker transmission, although a half dozen of us (including me) have had COVID.

[89th]

To me it’s pretty simple common sense that masks help reduce the transmission of human to human “stuff”. I don’t think it’s a perfect shield against covid micro particles or whatever but I’m sure it helps reduce things, so why not.

[George K]

@89th said in "Do Masks Work?":

To me it’s pretty simple common sense that masks help reduce the transmission of human to human “stuff”.

No disagreement there. The science of mask-wearing in the operating room is surprisingly scant.

I don’t think it’s a perfect shield against covid micro particles or whatever but I’m sure it helps reduce things, so why not.

So, let me get this straight.

1. Masks prevent human "stuff" from transmitting
2. Masks probably don't help with microparticles.

By that logic you should have been wearing a mask before the SARS-CoV-2 outbreak - but you weren't, were you?

[89th]

@george-k i’m not sure how to reply, you’re asking why didn’t I wear a mask before Covid?

I wear a mask now because it’s required by the places I visit and I respect that, and I also respect the fact that it could have a part in helping to reduce the spread of the pandemic. Just doing my part as a good citizen, IMO.

That being said, in general i’m comfortable without a mask because I am confident in my health and the vaccine I took.

[George K]

@89th said in "Do Masks Work?":

@george-k i’m not sure how to reply, you’re asking why didn’t I wear a mask before Covid?
I wear a mask now because it’s required by the places I visit and I respect that, and I also respect the fact that it could have a part in helping to reduce the spread of the pandemic. Just doing my part as a good citizen, IMO.
That being said, in general i’m comfortable without a mask because I am confident in my health and the vaccine I took.

Perhaps I overestimated your concern about human "stuff."

My sentiments are pretty much like yours, though I was never concerned about human "stuff" before the pandemic.

The article I posted shows that masking plays little, if any role, in halting the spread of the pandemic. Everything else is anecdotal.

If it's required, I'll mask up (our condo assn has reinstated the mask requirement for common areas), even though I'm not sure it really makes any difference.

At my age, I'm not as confident of my health, of course.

[bachophile]

“The science of mask-wearing in the operating room is surprisingly scant.”

Well, before covid, I basically thought the reason to wear a mask in the OR is not to have blood, gunk, or someones colon content splash in my face. I don’t think it adds jackshit to helping to keep sterility.

[Jolly]

@bachophile said in "Do Masks Work?":

“The science of mask-wearing in the operating room is surprisingly scant.”

Well, before covid, I basically thought the reason to wear a mask in the OR is not to have blood, gunk, or someones colon content splash in my face. I don’t think it adds jackshit to helping to keep sterility.

No face shields?

[Copper]

That’s funny

I didn’t think it was allowed to say no mask is better than a mask.

It may be correct, but it’s not a nice thing to say

It makes you a bad person

Kind of like the language AL uses

[bachophile]

I wear a mask and glasses. Anything that gets in between is my bad luck

[George K]

@bachophile said in "Do Masks Work?":

“The science of mask-wearing in the operating room is surprisingly scant.”

Well, before covid, I basically thought the reason to wear a mask in the OR is not to have blood, gunk, or someones colon content splash in my face. I don’t think it adds jackshit to helping to keep sterility.

Exactly. It’s a question of protecting yourself much more than protecting the patient.

As someone who has had projectile vomitus come up into his face, I’m a big believer in self protection, LOL.

[Doctor Phibes]

I think there's a case for wearing a mask out of simple politeness if you're going into an enclosed public area.

[Loki]

@89th said in "Do Masks Work?":

@george-k i’m not sure how to reply, you’re asking why didn’t I wear a mask before Covid?

I wear a mask now because it’s required by the places I visit and I respect that, and I also respect the fact that it could have a part in helping to reduce the spread of the pandemic. Just doing my part as a good citizen, IMO.

That being said, in general i’m comfortable without a mask because I am confident in my health and the vaccine I took.

+1

[Loki]

@doctor-phibes said in "Do Masks Work?":

I think there's a case for wearing a mask out of simple politeness if you're going into an enclosed public area.

Agreed. I am making no statement by wearing a mask and I don’t think I have the right to create conflict with absolute strangers. Just like BLM protesters have no right to shut down highways or destroy property.

[Copper]

@loki said in "Do Masks Work?":

@doctor-phibes said in "Do Masks Work?":

I think there's a case for wearing a mask out of simple politeness if you're going into an enclosed public area.

Agreed. I am making no statement by wearing a mask and I don’t think I have the right to create conflict with absolute strangers. Just like BLM protesters have no right to shut down highways or destroy property.

Clothes make the man

[Jolly]

@copper said in "Do Masks Work?":

@loki said in "Do Masks Work?":

@doctor-phibes said in "Do Masks Work?":

I think there's a case for wearing a mask out of simple politeness if you're going into an enclosed public area.

Agreed. I am making no statement by wearing a mask and I don’t think I have the right to create conflict with absolute strangers. Just like BLM protesters have no right to shut down highways or destroy property.

Clothes make the man

Pithy.

[George K]

I really hope I'm not coming of as an anti-masker here, because it's not my intent.

As I've said, many times, I've yet to see anything that comes close to real science about the effectiveness of masks with regard to COVID, until today.

Now, wearing one makes me feel better, and it's polite. It's also required, so I'm a good citizen as well, and I do so.

It's just not science, yet.

[Horace]

@george-k said in "Do Masks Work?":

I really hope I'm not coming of as an anti-masker here, because it's not my intent.

It’s how you make me feel.